New York Residents Only

Pursuant to New York Insurance Law section 2612 and Regulation 168 (11 NYCRR 244), Erie Insurance Group (“ERIE”) has procedures in place to protect the privacy and confidentiality of persons covered by an insurance policy that have a valid order of protection against the policyholder or other persons covered by the policy.

Upon delivery to ERIE by an insured of a valid order of protection, ERIE will for the duration of the order keep confidential and not disclose to the policyholder or other persons the insured’s address and telephone number; or the name, address, and telephone number of a person providing covered services to the insured. If a child is the insured, then this right may be asserted by the child’s parent or guardian.

New York Insurance Law section 2612 also requires health insurers, which includes Workers’ Compensation insurers, to accommodate a reasonable request made by a person covered by an insurance policy to receive communications of claim-related information by alternative means or at alternative locations. Except with the express consent of the person making the request, a health insurer may not disclose to the policyholder: (1) the address, telephone number, or any other personally identifying information of the person who made the request or child for whose benefit a request was made; (2) the nature of the health care services provided; or (3) the name or address of the provider of the covered services.

To make a request: To submit a valid order of protection or make a reasonable request, and to specify an alternative means of contact, please contact ERIE at the address and telephone number listed below.

To revoke a request: To revoke a request, an insured must send a notarized statement seeking revocation to the address below.

For information about domestic violence services, please contact the New York State Domestic and Sexual Violence Hotline by telephone at 1-800-942-6906, or access the website of the New York State office for the Prevention of Domestic Violence at http://www.opdv.ny.gov/help/dvhotlines.html.